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Posted on 11/29/2016

Calm again, Frank watched the tip of the needle disappear into his right shoulder.

I applied electrical leads to the pulse points on Frank’s head, chest, and feet while the docs reorganized the scattered equipment. Dr. Afzal added blood pressure cuffs, one on Frank’s left arm and another on his right lower leg to monitor the immediate ECT effects.

Frank looked at me. I took his hand in mine as his eyes glazed over. His eyelids fluttered in rhythm to his heartbeat until both eyes closed.

Dr. Umbar told us Frank was receiving IV Propofol, the same medication Michael Jackson received shortly before he died. It gave me the chills. I wasn’t concerned Frank would die, merely aware of a brief pall of sorrow paying me a visit from the King of Pop.

Within three minutes, Frank was deep in sleep.

“Dr. Umbar? Are we ready?” the psychiatrist asked.

Dr. Umbar nodded in agreement. “Good to go.”

Dr. Afzal looked to the black metal box. A paper strip spooled out like a receipt at a checkout stand.

He pressed the red button, holding it for a count of three seconds by the machine’s digital readout. Frank’s body twitched, just enough so you couldn’t miss it. His upper body and head spasms lasted six seconds. His fingers and toes continued their tiny dance for another dozen beats on the monitoring strip.

While we waited for the caffeine to kick in, I asked about Frank’s unexpected pre-ECT behavior.

“That was an unforeseen experience,” Dr. Afzal said. “I believe the anti-anxiety medication given on the unit beforehand induced an abnormal response.”

“Surely, that wasn’t all of it?” I asked.

“Frank talked to me last Friday,” said Dr. Afzal, “before my weekend off. He told me about a dream he’d had recently. It involved him rolling in a wagon through a dark cave, eventually landing in a sunny arena filled with children at attention, all outfitted in white playsuits. I think, this morning, our patient confused reality with his dream.”

“So,” Jerry said, “next time he walks here. No rolling.”

My goodness. It would have been nice to know about the damn dream.

Thirty minutes later, Frank was up, still groggy from the ECT and the assorted meds swirling around in his body.

Jerry helped him to the wheelchair.

The return trip seemed much longer than the previous one. I was still shaken by Frank’s outburst.

Hospital policy dictates one RN accompany patients to and from ECT and continually monitor health status two hours post-treatment. I charted Frank’s vital signs every fifteen minutes, relieved to see no blood pressure spikes, paranoia, fear, or loss of consciousness.

Short-term memory loss is a common side effect of ECT. The extent of memory loss after additional treatments would determine whether or not to continue the therapy. The positive aspects of ECT would be weighed against any detrimental memory loss.

It was warm where we sat in the day hall, sunlight streaming through the windows onto my assessment sheet.